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Old 03-21-2009, 04:46 PM   #2
Junior Member
Join Date: Mar 2009
Location: Salzburg, Austria
Posts: 25
Kerlin4321 HB User
Re: If you have had your big toe fused, please respond

Sorry you are going through this and especially sorry the cheilectomy did not give you pain relief. I am in much the same situation as you and am currently mulling over options. Did your doctor talk about the need for joint decompression at the time of your operation? My understanding is that in Hallux Rigidus at the stage you seem to have reached a simple cheilectomy is not enough - you need to achieve some sort of joint decompression as well or the structural issues (the constant jamming) are not addressed. So some sort of osteotomy that spares the joint should be performed. In advanced cases but for older, less active people a resection athroplasty (i.e. slicing off a small amount of the bone adjacent to the joint) can also help but you may lose the ability to plantar flex (put weight on the toe and push off) since no new cartilage fills the new space in the joint and the toe can become droopy. So apparently this is not recommended with most active people unless there is some other reason to do it (like maybe an over- long first metatarsal?) From what I have heard fusion can be very successful and is the best choice if your joint has virtually no cartilage left or you have very extensive osetoarthritis in the joint. The main issue seems to be lack of plantar flexion since the fused joint makes the toe point upward by some many degrees. The risk is that the distal phalanx (last bit of your great toe bone) and neighboring bones takes on too much pressure and create new gait or pain problems. But I have read accounts of many people very happy and active with fusions. Many of them had essentially rigid toes so it did not end up being a major change for them , just no pain and a return to a more normal gait. I am hoping to still salvage my joint(s) but realize a fusion may end up being my only option.

Hope you get some good feedback from those who have gone through it!